| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,257 |
2,593 |
$298K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,903 |
2,851 |
$268K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,676 |
2,631 |
$175K |
| V2020 |
Frames, purchases |
6,904 |
6,683 |
$174K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,399 |
1,375 |
$127K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,409 |
1,397 |
$79K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,888 |
2,821 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,108 |
887 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,808 |
1,758 |
$42K |
| 92250 |
|
1,035 |
941 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,831 |
3,723 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
283 |
279 |
$10K |
| V2756 |
Eye glass case |
5,431 |
5,293 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
90 |
89 |
$2K |
| 92134 |
|
14 |
12 |
$483.84 |
| 92015 |
Determination of refractive state |
306 |
299 |
$15.05 |